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Medicine Flashcards

7 cards from real NBME practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Medicine flashcards as text

  1. A 23-year-old woman started sulfamethoxazole-trimethoprim 10 days ago. She now presents with widespread erythematous targetoid lesions and mucosal ulceration involving her eyes, mouth, and genitalia. Nikolsky sign is positive. What is the most likely diagnosis?

    Answer: Stevens-Johnson syndrome / Toxic epidermal necrolysis

    Stevens-Johnson syndrome/TEN is a severe mucocutaneous drug reaction characterized by extensive epidermal detachment, mucosal involvement, and positive Nikolsky sign.

  2. A 38-year-old woman presents with 6 weeks of depressed mood, hypersomnia, weight gain, psychomotor retardation, and inability to concentrate. She denies any prior manic episodes. Which treatment is first-line for moderate-to-severe major depressive disorder?

    Answer: SSRI monotherapy (e.g., sertraline)

    SSRIs are first-line pharmacotherapy for major depressive disorder due to their efficacy, tolerability, and favorable side-effect profile.

  3. A 30-year-old man with a bee allergy is stung and develops urticaria, wheezing, hypotension (BP 78/50), and stridor within minutes. What is the immediate treatment of choice?

    Answer: Epinephrine 0.3 mg IM into the anterolateral thigh

    Intramuscular epinephrine to the anterolateral thigh is the first and most critical treatment for anaphylaxis, reversing bronchospasm, hypotension, and angioedema.

  4. A 54-year-old man presents with a 1.2 cm asymmetric pigmented lesion with irregular borders and multiple colors on his back. Dermoscopy shows atypical network and regression. What is the most appropriate next step?

    Answer: Full-thickness excisional biopsy with narrow margins

    A suspicious pigmented lesion should be removed by full-thickness excisional biopsy with narrow margins to allow accurate histological staging of Breslow thickness.

  5. A 24-year-old man is brought by his family with 8 months of social withdrawal, flat affect, disorganized speech, and auditory hallucinations telling him to harm himself. He has no substance use or medical causes identified. What is the most likely diagnosis?

    Answer: Schizophrenia

    Schizophrenia is characterized by positive symptoms (hallucinations, delusions), negative symptoms (flat affect, alogia), and functional decline lasting >6 months with no mood episode explanation.

  6. A 65-year-old man with CKD stage 4 is found to have K+ of 6.8 mEq/L on routine labs. ECG shows peaked T waves and widened QRS. Which intervention should be administered first?

    Answer: Calcium gluconate IV

    Calcium gluconate IV is given first to stabilize the cardiac membrane and prevent fatal arrhythmias; it acts within minutes and is essential when ECG changes are present.

  7. A 45-year-old woman with diabetes presents with a warm, erythematous, tender, well-demarcated area on her left lower leg with a fever of 38.8°C. There is no fluctuance or crepitus. Blood cultures are pending. What is the most likely causative organism?

    Answer: Staphylococcus aureus and Streptococcus pyogenes

    Non-purulent cellulitis is most commonly caused by beta-hemolytic streptococci (especially group A) and Staphylococcus aureus.